Basal metabolism factor



June 2l, 1932. E, MGKESSON 1,863,929

BASAL METABOLI SM FACTOR Filed May 2l. 1926 2 Sheets-Sheet l 'ez f f; 7 M /II f if 9.4/ J5 I f3 //0 E gf/ l ll/M, 36 5 0 l l! Z n i 47 5@ ,i l u `97 v7;

/aayg ./a/ fff^ y 5/ /l l /of juf n June 21, 1932. E MCKESSQN 1,863,929

BSALI METABOLISM FACTOR Filed May 21, 192s 2 sheets-sneer 2 l Y: o o o d6 o o o o o o o o o o ol l' bk o o o o o o o p o o o o o o o o Ugg 'Patented June 21, 1932 BATENT OFFICE m3 I. ICXESBON, 0l' TOLEDO, OIHIO BASAL IETABOLISI FACTOR Application led Icy 21, 1986. Serial No. 110,785.

measuring device;

Fig.

Fig. 2 is a section on the line II-IL Fig. 1;

ig. 3 is a section through the reservoir of the device of Fig. 1, showing parts broken away;

Fig. 4 is a view from the right of Fig. 3 with parts broken away;

Fig. 5 is an enlarged view of the tally apparatus device, parts being broken away, as seen from the left of Fig. 4;

Fig. 6 is asection on the line VI-VI,

Fig. 7 is a fragmenta detail view of the reservoir from the left o Fig. 1; and

Fig. 8 is a detail of the tally sheet herewith.

Pneumatic trough Mounted on legs 1 is base 2 having upstanding straight walls 3, 4, 5. and curved wall 6 terminating in upwardly open portion 7. At the upper region of the walls 3, 4, 5, along the upper edge of the wall 3 there extends shaft 7 mounted in bearingspS, 9. Mounted on this shaft 7 by bracket 10 is reservoir comprising upper straight portion 12 bordered by side portions 13, 14. Concentric with the shaft 7 from the side 12 and between sides 13, 14, extends short are side portion 15, and remote therefrom long arc side portion 16 in completing this upper reservoir or gas receiver, as a movable member in a pneumatic trough wherein the vessel 3, 4. 5. 6, is the container for liquid 17, which herein may be water.

As a counterpoise for the gas receiver, there is pivotally mounted on the shaft 7', arm 18 having thereon wei ht 19 adjustable toward and from the shaft by nut 20 on threaded portion 21. This nut 20 has extension rib 22 ack of threaded member 23 engaging block 55 24 fast with the weight 19. This wei ht 19, as mounted `on the guide stem 18 by t e nut 20 may have the gas receiver l2, 13, 14, 15, 1 6, 4rock thereupon. The extent of depression or counter-loading of the gas receiver b 50 this weight is determined by lug 25 fixed with the stem 18 abutting lug 26 fixed with the bracket 10. Accordingly, there may be a positioning approximately horizontal for the upper wall 12 of the gas receiver when scale a5 27 is at zero in reading as gau ed by the upper edge 28 of vessel side 6. lnob 29 may be grasped in rocking the gas receiver out of pneumatic trough co-operative position with 'the liquid containing vessel to permit charg- '10 ing of liquid 17 thereinto. In determinin liquid helghtto gauge line 30 in this vesse there may be draw-off of liquid therefrom by opening valve 3l.

Carbon dz'om'de removal u From the base 2, there is upwardly extendin g in this vessel 3, 4, 5, 6, tubular member 32. Disposed in this open top tubular member 32 as extending above the liquid 17, in the ves- 80' sel 3, 4, 5, 6, is container 33 having foraminous or screen -opening botton 34 as a support for soda lime 35 as a loose granular material. This vessel 33 is provided with outwardly extending drop fiange 36 which, as to its out- 85 wardly extending portion 37, rests on the open top of the tubular member 32 in providin a support for this container 33. The extent o the ange 36 downwardly therefrom is below the level of the liquid 17, and there is- 9o accordingly, thus provided a water seal insuring that all gas as entering chamber portion 38 below the screen 34 must pass through the soda lime 35 to gain entrance to the reservoir 12, 13, 14, 15, 16.

0mg/gen charging Compressed gas cylinder 39 for holding oxygen under pressure may have its valve 40 opened to provide communication by duct 41 10o and fitting 42 through passage 43 and flat rubber double wall flap 14 having side openings 45 on the opening of the flap for discharging the oxygen into the chamber 38. This-rubber device 44, 45, is a one-way flow or check valve device sensitive to most minnte diil`erences in pneumatic pressure. As the reservoir 12, 13, 14. 15, 16, is elevated to a desired reading by the flow of oxygen through the soda lime 35 thereinto, with the device stoppered to preclude discharge therefrom, the valve 40 of the oxygen supply 39 may be cut oli and the apparatus be in condition for starting operations hereunder.

The circuit Adjacent the tubular member 32, as a ma- ]or or inlet passage to the receiver, there 1s minor tubular member 46 extending above the liquid 17 in the reservoir from wall 47' as spaced upwardly from the base 2.

This tubular member 46 has water seal depending flange 0r skirt 48 about the tubular member 4G, while inwardly this member 46 is provided with rubber flap type of check valve 44, 45, as an outlet or discharge valve from the gas receiver, it being reversely placed as to the inlet valve in the chamber 38. This outflow-permitting, but reverse-flow-precluding check valve 44, 45, in the member 46, allows gas low from the gas receiver 12, 13, 14, 15, 16, into tubular member 46 and fitting 49 where is located thermometer 50 having scale 51 as an indicator for the temperature condition to be considered in the computations as for gas volume hereunder.

From the fitting 49, there is branch duct 51 to mask 52 having mouth portion 53. This mask is preferably of yieldable material, as rubber, and mayhave lugs 54 upon which the patient may grip with the teeth in holding the mask in position. From this mask, as having breathing opening 55 from the duct 51, there is communication with duct 56 extending to the fitting 42. Accordingly, with this mask or inhaler nozzle in position with the patient. there may be the complete cycle of respiration with the duct 56 taking the exhalations and the duct 51 supplying the inhalation gas.

I nhaler 'mounting The frame of the vessel is herein shown as provided with lugs 57, 58, carrying pivot pins 59, 60, from which upwardly extend link 61 and arm 62. The link 61 is connected to the arm 62 by pivot pin 63 at clamp 64. The arm 62 is tubular and serves as a guide for rod 65 terminating in hook 66 for engagement with eye 67 at the mask 52. Accordingly, the rod 65 may he telescoped as desired into or out of tubular arm 62. The inclination of the arm 62 as to the vessel may be determined by the position along the. arm 62 at which the clamp 64 is adjusted by the wing nut 63.

'lhe angular rocking position of the arm 62 as to the vessel 63 may be determined by adjusting the wing nut 60.

Recording time function device Below the side 3 of the vessel, there is mounted housing 68 containing a speed reduction gearing train having actuating shaft 69 with escapement wheel 70, balance wheel 71 for operating said escapement, and brake shaft 72 having arm 73 rockable to engage the balance wheel 71 so that by rocking such brake against the wheel, the gearing may be stopped, while oscillating said brake against the wheel the gearing may be started.

Mounted on the shaft 69 is drum 74 carrying tapered pins 75. This shaft 69 as protruding from the housing 68 and connected to the drum 74, has such shaft 69 carried in frame members 76, 77. These frame members 76'. 7 7 have under the overhang portion 47, upwardly open forks 78 in which may he mounted shaft 79 carrying roll 8O of strip material having web 81 therefrom extending under guide shoes 82 as rockable by arm 83 on pivot 84 against the resistance of spring 85. These shoes 82 serve to hold the web 81 of strip material, as paper, into coacting relation with the annular sets of pins at each end of the drum 74. When it is desired to rotate the drum, say for registering the web 81 with the rolls or otherwise feeding such off, this may be done by backing knurled wheel 86 to free the drumf74 for turning in the desired direction. The free end of this web 81, as hanging down over the drum 74 is engaged by spring paper clip 87 having weighted release portions 88. This provides a clockweight or gravity actuator for the gearing escapement in the housing 68, introducing through the escapement. a controlled time function for the feeding of the strip in the movement over the drum 74. Regulator 88 adjusts the escapement. The computed time interval and drum diameter as herein adopted is slightly less than the spacing of holes 89 in the web 81 for the pin 75. This is a material factor against stretching, binding, crowding or other distortion of the web of paper or other stock, which might arise from different atmospheric conditions notwithstanding the paper might be accurately calibrated by transverse cross-section lining 90, 91.

Record 'writer Knurled ring 92 on the shaft 7 serves as a friction clamp for arm 93 carrying extension 94, the rotary extent of which may ne adjusted by screws 95 in slots 96 in the arm 94. This arm 94 is connected to flexible line or cord 97 extending about guide rollers 98, 99, 100, carried by the frame members 7 6, 77. This line or cord 97 has in its extent about these rollers 98, 99, 100, a constant tension 1,ses,eae

take-up connection by way of sprin 101 in its closed circuit connection with t e arm extension 94. This cord has connection 102 with carrier 103 mounted by rollers 104 to slide on track 105 between the frame members 76, 77, in the vicinity of the guide rollers 98, 99. This carrier 103 has glass pen polnt 106 from tubular portion 10'1 in communication with collapsible rubber bag reservoir 108 in thus providing a fountain pen in contact with web 81 of the paper as hanging downward after passing over the drum 74 as such paper is drawn from the roll 80.

0mg/gen depletion operation After the reservoir 12, 13, 14, 15, 16, has been charged, say with nine liters gas capacity by supplying oxygen from the tank 39 with the mask 52 held closed so that there is no oxygen escape by flowing toward the mask 52, the reading may be taken and the apparatus placed in condition for use with a patient. To this end, ink point 106 may be brought into registry with point 109 as a zero line of a transverse graduation on the web 81 of the paper record. This adjustment is obtained by operating the knurled wheel 86 to the desired point. These zero points on the web 81 are in this instance provided by the lines 90 into minutes and the lines 91 into tenths of minutes with the scale being one for each six minutes or a tenth of an hour. This positioning of the pen point 106 may be obtained by adjusting the knurled head 110 of stop on bracket 111 carried by the vessel from adjacent side 3 thereof and extending along side 4. The web 81, of the record strip, is shown as having extending longitudinally thereof, lines 112 as liter lines and lines 113 as one-tenth liter lines.

Operation As the patient is in position at the mask 52 and the needle point 106 is at zero point 109 on the web 81 of paper, the handle 72 may be oscillated to start the escapement so that the weighted paper clip 87, 88, may draw the stock as the patient begins breathing in this closed circuit device. The exhalation of the patient is by Way of duct 56 through check valve 44, 45, the chamber 38, thence through the soda lime 35 into the receiver above the liquid 17 to lift the receiver 12, 13, 14, 15, 16, to rock with its shaft 7. The passage of this exhalation gas through the soda lime 35 removes the carbon dioxide from such exhalation and allows only oxygen and such nitrogen as may be in the circuit to enter this pneumatic trough member. Upon inhalation, the patient draws gas from this pneumatic trough reservoir through one-way check valve 44, 45, of rubber into tubular member 46 through fitting 49 and duct 51 to the mask 52, as an inhalator. This depletion of the capacity of the chamber 12, 13, 14, 15,

16, causes such to descend in rocking with the shaft 7 This oscillation of the receiver 12, 13, 14, 15, 16, down with the inhalation, and up with each exhalation is transmitted directly by the x11-111,94 to el'ect writing by the pen point 106 on the web 8l-as fed by the determined timing mechanism 68. These 0S- cillations by the pen` point 106 effect writing lines 114 as a sort of sign curve. As the pa tient consumes the oxygen from this closed 76 circuit, say over the six minute interval, the oscillations which may be uniform if the breathing by the patient be uniform throughout the test, depart from the zero point 109 toward the opposite side of the recordstrip.

Due to the constant lineal travel rate of this record strip 81,y if the inhalation-exhalation cycles be constant, the sign curves or vibration interval records would be uniform. Any unusual breathing, as longI timeinterval or greater inhalation or greater exhalation, will show on these lines of Writing, so there is a direct record of patient performance. Additionally, the point is that from this zero point the line of the lower points of these writings determines an oxygen consumption rate line 115 which, say in the instance shown, gives a reading of 2200 c. c. of oxygen or 2.2 liters in six minutes, which is at the rate of 22 liters per hour. This is a basis which may be of exceptional value in determining the physical condition of a patient more particularly as to whether or not there is departure from what should be the normal oxygen consumption for an individual of a size, age, as Well as sex. Departures from the normal thus enable the diognostician to take such definitely into consideration as to Whether there is from such basal metabolism calculations, possible thyroid troubles or other pathological disturbances, and whether such are above or below normal.

The line of writing on the record is directly available for definitely ascertaining pathological conditions. The thermometer 51, as in degrees centrigrade, provides a factor as does the barometrie pressure. Calculations may be tabulated, say as to 80% aqueous vapor at 60 millimeter pressure by giving 115 a reading responsive to this condition of the 22 liters per hour,assumingthebarometer to be 090 and the temperature to be 20 C. This gives a factor of 4 and the result from the use thereof gives the term 88 calories per 120 hour. There is a loss in calories per individual according to the surface area of such individual, factors of Which are the Weight in pounds of the individual as Well as the height of the individual in inchesil Assuming the individual weighs 180 lbs. and is 71 inches high, there is computation of 2 to be used as a devisor giving the resultant of 44 calories per square meter per hour. There is next the factor of the sex and age of the individual, and assuming the individual to have been female and age 34, the calories obtained` 44. check as for .such an individual as being 21%y above normal. This is accordingly resultant from the calculations as pe'rtinent to the test to be considered in the diagnosis assuming the, patient is not disturbed by digestion action, fever', or exercise.

What is claimed and it is desired to secure by United States Letters Patent is:

l. An oxygen consumption measuringapparatus comprising a carbondioxide eliminator, a one-way valve therefrom, a one-Way valve thereto, a connection away from the eliminator and between said valves for receiving pulsations of inhalation for withdrawing oxygen from the apparatus and pulsations of exhalation for delivering carbon dioxide to the apparatus to be thereby effective for alternately opening said valves in the sequence of said pulsations, a variable capacit v reservoir between the eliminator and valve therefrom to have its contents depleted by said connection operation, said reservoir embodying a rockable member and a mounting bearing therefor, and time-volume measuring means for directly disclosing the rate of oxygen consumption from the degree of depletion in capacity of said reservoir, including an arm fixed with the rockable member of the reservoir and time controlled movable means providing a way over which said arm is operable directly with the rockings of the member for defining the rate of said depletion.

2. An oxygen circuit device comprising a liquid container having a wall, a housing open into and inovable-out-of liquid in the container as a reservoir for oxygen, inlet and outlet valves, tubular means in which the valves are located, said tubular means extending out of the liquid into said reservoir there to expose a joint, and enveloping means for .said lioint extending for submergence in the liquid.

3. An oxygen circuit device comprising a liquid container having a wall, a housing open thereto and pivotally mounted thereon for movement therefrom as a uniform pressure variable capacity reservoir, circuit Way providing means including a duct extending through the container Wall into the housing .thereto expose a joint, and a removable check valve in said duct have enveloping means for said joint and extending into the liquid of the container.

4. A gas eliminator, a container about the eliminator, said container being for a liquid, a variable capacity reservoir over said eliminator extending into the liquid of said container, controlling means maintaining one direct-ion of circuit flow as to the eliminator embodying a duct to the eliminator remote from the ieservoir there to expose a joint between the eliminator and container adjacent said reservoir, a second duct extending directly to the reservoir independently of the eliminator, and enveloping means at the joint extending into submerging position in liquid in said container. v

5. A shiftable reservoir, a fixed axis mounting therefor, depletion connection means coactiiig in effecting reservoir shifting for rocking on said axis, reservoir shifting disclosing means embodying an arm angularly adjustable about said axis relatively to andoperable by the oscillation shifting of the reservoir on said axis, a guide, an indicator carried by the guide, a slack, take-up transmission connection from the arm for reciprocatin the indicator in two directions along the guide in synchronism with the rocking of the reservoir, and a scale adjacent the guide with which the indicator may coact.

In witness whereof I atlix my signature.

ELMER I, MCKESSON. 

